Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Gilla999]

My story is quite unusual and I would really appreciate feedback / opinions on whether I was ever even in Perimenopause to begin with.

In 2018 ish (age 39) I started suffering with extremely painful, swollen, heavy boobs every month like clockwork from Day 14 to Day 28. It became so uncomfortable that I eventually had a Rhythm hormone test done which showed that my Estrogen levels were very high, particularly spiking from Day 14 onwards - which matched what I experienced. My Progesterone was also over the top of the range, but not by as much proportionately. Around this time my cycles also shortened from their 33 days to around 27 days.

This lasted for around 3 years, in then in March 2020 I noticed it stopped happening. However what replaced at the same time was debiltating night sweats and 3am insomnia during exactly the same time period - from Day 14 to Day 28, like clockwork. Between Days 1-14 I was absolutely fine. I was still having periods and ovulating but a blood test on Day 21 at this time showed my Estrogen was now only 245 pmol and after a year of utter menopausal hell and speaking to a private meno specialist I was put on Lenzetto - 2 sprays a day - and pretty much immediately the night sweats and insomnia disappeared. My Estrogen blood tests I had during the proceeding year (always on Day 21 of my cycle) were relatively high (always between 600-800 pmol), but I was told by menopause consultants this was not unusual for younger women.

All sounds ok/normal so far, right?

But what doesn't make any sense to me and has made me question everything, is that (a) three years later I am still ovulating every month (I test with sticks every month) and (b) in December just gone my own Estrogen shot up again and has stayed high since. This has triggered a whole bunch of allergy/autoimmune issues for me because now my total Estrogen is super high at around 900-1000 pmol, and I am struggling to reduce my HRT without getting withdrawal side effects.

My understanding of perimenopause was that your Estrogen is often high at the beginning, then starts to fluctuate as ovulation becomes more sporadic, then eventually Estrogen consistently falls/flatlines when your periods stop. Nowhere in the literature have I read about a surge in Estrogen that lasts for two years, followed by a sudden and sharp decline in Estrogen that lasts for another two years, then another sudden surge back up again - all the while still ovulating every month.

It has made me question whether there could have been (still be?) something else going on with my hormones that would cause these changes, but I can't for the life of me think of what. I realise some fluctuations are normal at any age, but I have experienced such huge swings which have caused debilitating menopause like symptoms, and these swings seem to last a couple of years each. The final confusing piece of the puzzle is that when I started HRT, I gained a considerable amount of weight - about 1.5 stone rapidly in six weeks, and began suffering from chronic constipation. I know for sure that the constipation is caused by the Estrogen as I've experimented. It's never sat well with me that HRT would cause these side effects if it was the "right" thing or level for my body. And yet it did immediately take away the night sweats and 3am insomnia.

Has anyone heard of any other hormonal conditions that could cause something like this, or any other similar stories or thoughts/opinions?

[Hurdity]

Hi Gilla999

Peri-menopause is defined clinically as starting when your cycle length  varies from month to month by 7 days - and that is the point at which HRT is indicated to prevent the oestrogen crash which occurs mid and end cycle. Measurement of oestrogen levels is a sidetrack and unnecessary!

Prior to this point however, hormone levels do begin to go awry and some women do start to experience menopausal symptoms and/or increase pms due to the fluctuations especially and in some cases HRT does help (though for some women it only makes things worse at this early stage!)

What you describe - the cycles shortening - is the stage BEFORE  peri-menopause ( as defined medically) known as the late reproductive stage or phase - I will post a link to the paper describing the stages of reproductive ageing (STRAW). While not every woman is going to experience menopause exactly as outlined broadly it gives the picture. So the ovaries are still functioning and therefore not peri-menopausal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340903/ (I haven't read this recently and don't know if there has been an update).

That is not to diminish any symptomatic changes occurring before this, but which can be difficult to treat.

When you say you ovulate each month through testing with sticks - is this accurate? If you are ovulating every month during the whole time and now - even while experiencing  variable oestrogen levels ( remember these are not accurate and oestrogen levels vary throughout the cycle and when on HRT) and various symptoms,  then you are not and have never yet been, peri-menopausal (according to the medical definition).

Re maybe becoming peri-menopausal briefly and then ovulation resuming - in younger women this is a known phenomenon, which is why in women under 50 contraception is advised for two years following the last period, instead of for only one year post-50 - because periods can resume. I suppose it is semantics - calling the whole stage peri-menopause or not but I hope you get what I mean here?

If you want to stop the fluctuations you are still young enough to go on one of the pills eg QLAIRA or ZOELY which contain estradiol but suppress ovulation and therefore will stabilise hormone levels, and give you contraception too - if you want this.

Hope this helps?

Hurdity x

[Gilla999]

Thanks Hurdity, I really appreciate the reply and this is certainly food for thought (and I understand you're not trying to diminish experiences etc).

Yes, my cycles shortening was the stage I had for two years before I started experiencing side effects from low Estrogen. I didn't think I was perimenopausal at that first stage, it was only when my Estrogen then began to plummet and I became very symptomatic from that that I thought I had entered Perimenopause. Initially I tried Zoely contraceptive Pill for 4 months and then Yasmin for 3 months, and neither resolved my very strong low Estrogen symptoms. Due to my symptoms and my Day 21 blood test being 245 pmol (which my menopause specialist told me is indicated for HRT use) I then started Lenzetto which fixed things pretty much immediately.

But what just doesn't fit the picture is 1. How three years later i am still ovulating every month and 2. Why my Estrogen has suddenly shot back up again for the last few months. If my Estrogen levels are currently consistently circa 900 pmol on Day 21, I must still be making a decent amount of my own Estrogen - which is very different from the three years prior when it dropped very low.

The only thing I can come up with is that something else hormonally has been going on that has made my Estrogen surge for a couple of years, then drop for three years, then surge again. But I can't seem to find any kind of hormone condition that would cause that. It's very strange and makes me feel a bit isolated and confused in my experience. Perhaps I will never know or understand why my hormones have wrecked my life over the last four years and I need to come to terms with that 

PS. Yes I test with ovulation sticks every month and they are as accurate as can be (and my FSH/LH also show I'm ovulating).

Thanks again for the rely Hurdity x

[Hurdity]

Hi Gilla999

As far as I understand it, this is not any particular hormonal condition as such, but a normal part of that process we women go through called menopause! There is no actual standard despite the different stages of reproductive ageing having been characterised as per that link I gave ie each woman's experience will be subtly ( or not so subtly) different....

In fact in that link, towards the end it says this:

"The course of reproductive aging in women with POI/premature ovarian failure seems to be considerably more variable than that of women with normal reproductive aging. Not only are there several potential etiologies but also a substantial proportion of women have spontaneous resumption of menstrual function once the diagnosis has been confirmed, including ovulation and successful spontaneous pregnancy.76 Additional research is needed to better document the process of ovarian aging in these women and whether the course of ovarian aging differs by etiology of POI. Studies of reproductive aging in POI are considered to be a research priority." (my bold)

Although you say you have been ovulating the whole time, the shortened cycles do indicate you were nearing peri-menopause....

"But I can't seem to find any kind of hormone condition that would cause that. It's very strange and makes me feel a bit isolated and confused in my experience. Perhaps I will never know or understand why my hormones have wrecked my life over the last four years and I need to come to terms with that "

I'm sorry that you feel your hormones have wrecked four years of your life, but yes I think the exact mechanism by which our individual bodies go through the myriad of hormonal changes as we approach menopause, may remain a mystery - though in principle it is expected. In your case, unless premature menopause is in the family, then this is the question - why did your body decide to approach menopause - or rather enter the late reproductive stage - at a relatively young age?

I think you will torment yourself if you continue to dwell on this, and as you say, accepting that your body did start to go through changes then, is the way forward. The most important thing is to focus now on what you need to do to feel better. You said you used Zoely - but that is lower oestrogen - Qlaira is variable but much higher - so perhaps it is worth trying that if you want  a bit more stability and want to prevent ovulation. However if you are feeling well on your current regime then keep on with it, but I really suggest stop getting hung up on oestrogen levels and having them measured - it doesn't really matter unless you feel that because you are ovulating and levels are high, that you don't need HRT? Provided the dose is not exceptionally high then it is unlikely to be too high, if you feel well?

I don't think I've helped much here as I don't have an answers, but hopefully a little.

Wishing you well - and just try to relax

Hurdity x

[CLKD]

Hurdity - U have given good advice.  Something to see if it suits where Gilla999 is right now.

[Gilla999]

Hurdity you have actually helped a lot - and thanks again for taking the time to reply. I wasn't even aware of premature ovarian failure, and what you've described from that link really does sound very similar to what I've gone through. I don't have a history of early menopause in the family and the only connections I can think of are (a) I don't have any children, which I read somewhere can influence and (b) I had a miscarriage about a year before i went into early menopause. But as you very rightly say, I need to accept that I will probably never understand the true picture of what has happened, or why my experience has seemed so different from most.

Blood tests aside I do believe my Estrogen is too high and really do question now whether I need to be on it at all (because of a whole bunch of side effects/problems as well as the regular ovulating) but I have to reduce very slowly or I get some sort of 'withdrawal' from doing so (similar to the withdrawal I get from Antidepressants if I reduce too fast - I also have to go at a snail's pace there).

I can only try gradually cutting down and hope things improve and I'll have a think about the Qlaira - thanks again Hurdity x